Purtscher‐like retinopathy associated with systemic lupus erythematosus treated with rituximab plus low‐dose interleukin‐2: A case report

Abstract

AbstractPurtscher‐like retinopathy, an occlusive microvasculopathy, is a rare and severe ophthalmic complication of systemic lupus erythematosus (SLE) characterized by a sudden loss of vision with retinal whitening, cotton wool spots and minimal intraretinal hemorrhage. Recovery in visual acuity is usually poor even with prompt treatment. This case showed a patient with SLE concurrent Purtscher‐like retinopathy treated with rituximab and interleukin‐2 (IL‐2) with good prognosis. A 16‐year‐old female with a 2‐year history of SLE was admitted because of unrelieved disease activity of SLE when treated with a high dose of corticosteroids and immunosuppressants and she further suffered from reduced visual acuity in both eyes. She was diagnosed with Purtscher‐like retinopathy secondary to SLE after ocular examination. Rituximab and low‐dose IL‐2 for systemic treatment and intravitreal injection of anti‐vascular endothelial growth factor antibody to right eye were given. The SLE disease was completely relieved with the sight recovering and no recurrence of Purtscher‐like retinopathy was reported during 6‐year follow‐up. Purtscher‐like retinopathy associated with SLE should be treated early and promptly. Rituximab should be considered in SLE patients with Purtscher‐like retinopathy who have an incomplete response to initial immunosuppressive therapy and low‐dose IL‐2 may help induction of clinical remission.